Abstract
Background Sensitization to profilins and other cross-reacting molecules might hinder proper specific immunotherapy (SIT) prescription in polysensitized patients with pollen-related allergic rhinitis (AR). In these patients, component-resolved diagnosis (CRD) might modify SIT prescription by improving the identification of the disease-eliciting pollen sources. Objectives We sought to measure the effect of CRD on SIT prescription in children with pollen-related AR. Methods Children (n = 651) with moderate-to-severe pollen-related AR were recruited between May 2009 and June 2011 in 16 Italian outpatient clinics. Skin prick test (SPT) reactivity to grass, cypress, olive, mugwort, pellitory, and/or Betulaceae pollen was considered clinically relevant if symptoms occurred during the corresponding peak pollen season. IgE sensitization to Phl p 1, Phl p 5, Bet v 1, Cup a 1, Art v 1, Ole e 1, Par j 2, and Phl p 12 (profilin) was measured by using ImmunoCAP. SIT prescription was modeled on SPT responses first and then remodeled considering also CRD according to GA2LEN-European Academy of Allergology and Clinical Immunology guidelines and the opinions of 14 pediatric allergists. Results No IgE to the respective major allergens was detected in significant proportions of patients with supposed clinically relevant sensitization to mugwort (45/65 [69%]), Betulaceae (146/252 [60%]), pellitory (78/257 [30%]), olive (111/390 [28%]), cypress (28/184 [15%]), and grass (56/568 [10%]). IgE to profilins, polcalcins, or both could justify 173 (37%) of 464 of these SPT reactions. After CRD, the SPT-based decision on SIT prescription or composition was changed in 277 (42%) of 651 or 315 (48%) of 651 children according to the European or American approach, respectively, and in 305 (47%) of 651 children according to the opinion of the 14 local pediatric allergists. Conclusions In children with pollen-related AR, applying CRD leads to changes in a large proportion of SIT prescriptions as opposed to relying on clinical history and SPT alone. The hypothesis that CRD-guided prescription improves SIT efficacy deserves to be tested.
| Original language | English |
|---|---|
| Journal | Journal of Allergy and Clinical Immunology |
| Volume | 134 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2014 |
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Keywords
- Allergic rhinitis
- children
- component-resolved diagnosis
- IgE
- panallergens
- pollen
- profilin
- specific immunotherapy
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
- Medicine(all)
Cite this
The effect of component-resolved diagnosis on specific immunotherapy prescription in children with hay fever. / Stringari, Giovanna; Tripodi, Salvatore; Caffarelli, Carlo; Dondi, Arianna; Asero, Riccardo; Di Rienzo Businco, Andrea; Bianchi, Annamaria; Candelotti, Paolo; Ricci, Giampaolo; Bellini, Federica; Maiello, Nunzia; Miraglia Del Giudice, Michele; Frediani, Tullio; Sodano, Simona; Dello Iacono, Iride; Macrì, Francesco; Peparini, Ilaria; Povesi Dascola, Carlotta; Patria, Maria Francesca; Varin, Elena; Peroni, Diego; Comberiati, Pasquale; Chini, Loredana; Moschese, Viviana; Lucarelli, Sandra; Bernardini, Roberto; Pingitore, Giuseppe; Pelosi, Umberto; Tosca, Mariangela; Cirisano, Anastasia; Faggian, Diego; Travaglini, Alessandro; Plebani, Mario; Matricardi, Paolo Maria.
In: Journal of Allergy and Clinical Immunology, Vol. 134, No. 1, 2014.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The effect of component-resolved diagnosis on specific immunotherapy prescription in children with hay fever
AU - Stringari, Giovanna
AU - Tripodi, Salvatore
AU - Caffarelli, Carlo
AU - Dondi, Arianna
AU - Asero, Riccardo
AU - Di Rienzo Businco, Andrea
AU - Bianchi, Annamaria
AU - Candelotti, Paolo
AU - Ricci, Giampaolo
AU - Bellini, Federica
AU - Maiello, Nunzia
AU - Miraglia Del Giudice, Michele
AU - Frediani, Tullio
AU - Sodano, Simona
AU - Dello Iacono, Iride
AU - Macrì, Francesco
AU - Peparini, Ilaria
AU - Povesi Dascola, Carlotta
AU - Patria, Maria Francesca
AU - Varin, Elena
AU - Peroni, Diego
AU - Comberiati, Pasquale
AU - Chini, Loredana
AU - Moschese, Viviana
AU - Lucarelli, Sandra
AU - Bernardini, Roberto
AU - Pingitore, Giuseppe
AU - Pelosi, Umberto
AU - Tosca, Mariangela
AU - Cirisano, Anastasia
AU - Faggian, Diego
AU - Travaglini, Alessandro
AU - Plebani, Mario
AU - Matricardi, Paolo Maria
PY - 2014
Y1 - 2014
N2 - Background Sensitization to profilins and other cross-reacting molecules might hinder proper specific immunotherapy (SIT) prescription in polysensitized patients with pollen-related allergic rhinitis (AR). In these patients, component-resolved diagnosis (CRD) might modify SIT prescription by improving the identification of the disease-eliciting pollen sources. Objectives We sought to measure the effect of CRD on SIT prescription in children with pollen-related AR. Methods Children (n = 651) with moderate-to-severe pollen-related AR were recruited between May 2009 and June 2011 in 16 Italian outpatient clinics. Skin prick test (SPT) reactivity to grass, cypress, olive, mugwort, pellitory, and/or Betulaceae pollen was considered clinically relevant if symptoms occurred during the corresponding peak pollen season. IgE sensitization to Phl p 1, Phl p 5, Bet v 1, Cup a 1, Art v 1, Ole e 1, Par j 2, and Phl p 12 (profilin) was measured by using ImmunoCAP. SIT prescription was modeled on SPT responses first and then remodeled considering also CRD according to GA2LEN-European Academy of Allergology and Clinical Immunology guidelines and the opinions of 14 pediatric allergists. Results No IgE to the respective major allergens was detected in significant proportions of patients with supposed clinically relevant sensitization to mugwort (45/65 [69%]), Betulaceae (146/252 [60%]), pellitory (78/257 [30%]), olive (111/390 [28%]), cypress (28/184 [15%]), and grass (56/568 [10%]). IgE to profilins, polcalcins, or both could justify 173 (37%) of 464 of these SPT reactions. After CRD, the SPT-based decision on SIT prescription or composition was changed in 277 (42%) of 651 or 315 (48%) of 651 children according to the European or American approach, respectively, and in 305 (47%) of 651 children according to the opinion of the 14 local pediatric allergists. Conclusions In children with pollen-related AR, applying CRD leads to changes in a large proportion of SIT prescriptions as opposed to relying on clinical history and SPT alone. The hypothesis that CRD-guided prescription improves SIT efficacy deserves to be tested.
AB - Background Sensitization to profilins and other cross-reacting molecules might hinder proper specific immunotherapy (SIT) prescription in polysensitized patients with pollen-related allergic rhinitis (AR). In these patients, component-resolved diagnosis (CRD) might modify SIT prescription by improving the identification of the disease-eliciting pollen sources. Objectives We sought to measure the effect of CRD on SIT prescription in children with pollen-related AR. Methods Children (n = 651) with moderate-to-severe pollen-related AR were recruited between May 2009 and June 2011 in 16 Italian outpatient clinics. Skin prick test (SPT) reactivity to grass, cypress, olive, mugwort, pellitory, and/or Betulaceae pollen was considered clinically relevant if symptoms occurred during the corresponding peak pollen season. IgE sensitization to Phl p 1, Phl p 5, Bet v 1, Cup a 1, Art v 1, Ole e 1, Par j 2, and Phl p 12 (profilin) was measured by using ImmunoCAP. SIT prescription was modeled on SPT responses first and then remodeled considering also CRD according to GA2LEN-European Academy of Allergology and Clinical Immunology guidelines and the opinions of 14 pediatric allergists. Results No IgE to the respective major allergens was detected in significant proportions of patients with supposed clinically relevant sensitization to mugwort (45/65 [69%]), Betulaceae (146/252 [60%]), pellitory (78/257 [30%]), olive (111/390 [28%]), cypress (28/184 [15%]), and grass (56/568 [10%]). IgE to profilins, polcalcins, or both could justify 173 (37%) of 464 of these SPT reactions. After CRD, the SPT-based decision on SIT prescription or composition was changed in 277 (42%) of 651 or 315 (48%) of 651 children according to the European or American approach, respectively, and in 305 (47%) of 651 children according to the opinion of the 14 local pediatric allergists. Conclusions In children with pollen-related AR, applying CRD leads to changes in a large proportion of SIT prescriptions as opposed to relying on clinical history and SPT alone. The hypothesis that CRD-guided prescription improves SIT efficacy deserves to be tested.
KW - Allergic rhinitis
KW - children
KW - component-resolved diagnosis
KW - IgE
KW - panallergens
KW - pollen
KW - profilin
KW - specific immunotherapy
UR - http://www.scopus.com/inward/record.url?scp=84903748177&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84903748177&partnerID=8YFLogxK
U2 - 10.1016/j.jaci.2014.01.042
DO - 10.1016/j.jaci.2014.01.042
M3 - Article
C2 - 24794684
AN - SCOPUS:84903748177
VL - 134
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
SN - 0091-6749
IS - 1
ER -